|
HC LYMPHOCYTE PROLIFERATION, MITOGENS
|
Facility
|
IP
|
$264.91
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200473
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$198.68 |
| Max. Negotiated Rate |
$264.91 |
| Rate for Payer: Aetna Commercial |
$238.42
|
| Rate for Payer: ASR ASR |
$256.96
|
| Rate for Payer: BCBS Trust/PPO |
$217.54
|
| Rate for Payer: BCN Commercial |
$217.54
|
| Rate for Payer: Cash Price |
$211.93
|
| Rate for Payer: Cofinity Commercial |
$249.02
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$211.93
|
| Rate for Payer: Healthscope Commercial |
$256.96
|
| Rate for Payer: Healthscope Whirlpool |
$264.91
|
| Rate for Payer: Mclaren Commercial |
$238.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$225.17
|
| Rate for Payer: Nomi Health Commercial |
$217.23
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$198.68
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$233.12
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
IP
|
$285.69
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$214.27 |
| Max. Negotiated Rate |
$285.69 |
| Rate for Payer: Aetna Commercial |
$257.12
|
| Rate for Payer: ASR ASR |
$277.12
|
| Rate for Payer: BCBS Trust/PPO |
$234.61
|
| Rate for Payer: BCN Commercial |
$234.61
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cofinity Commercial |
$268.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.55
|
| Rate for Payer: Healthscope Commercial |
$277.12
|
| Rate for Payer: Healthscope Whirlpool |
$285.69
|
| Rate for Payer: Mclaren Commercial |
$257.12
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Nomi Health Commercial |
$234.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.41
|
|
|
HC LYMPHOCYTE PROLIFERATION, MITOGENS CMPT
|
Facility
|
OP
|
$285.69
|
|
|
Service Code
|
CPT 86353
|
| Hospital Charge Code |
30200474
|
|
Hospital Revenue Code
|
302
|
| Min. Negotiated Rate |
$25.64 |
| Max. Negotiated Rate |
$285.69 |
| Rate for Payer: Aetna Commercial |
$257.12
|
| Rate for Payer: Aetna Medicare |
$49.03
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$61.29
|
| Rate for Payer: Amish Plain Church Group Commercial |
$61.29
|
| Rate for Payer: ASR ASR |
$277.12
|
| Rate for Payer: BCBS Complete |
$26.93
|
| Rate for Payer: BCBS MAPPO |
$49.03
|
| Rate for Payer: BCBS Trust/PPO |
$235.55
|
| Rate for Payer: BCN Commercial |
$235.55
|
| Rate for Payer: BCN Medicare Advantage |
$49.03
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cash Price |
$228.55
|
| Rate for Payer: Cofinity Commercial |
$268.55
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$228.55
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$49.03
|
| Rate for Payer: Healthscope Commercial |
$277.12
|
| Rate for Payer: Healthscope Whirlpool |
$285.69
|
| Rate for Payer: Humana Choice PPO Medicare |
$49.03
|
| Rate for Payer: Mclaren Commercial |
$257.12
|
| Rate for Payer: Mclaren Medicaid |
$49.03
|
| Rate for Payer: Mclaren Medicare |
$49.03
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$51.48
|
| Rate for Payer: Meridian Medicaid |
$26.93
|
| Rate for Payer: MI Amish Medical Board Commercial |
$56.38
|
| Rate for Payer: Molina Medicare/Medicaid |
$53.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$242.84
|
| Rate for Payer: Nomi Health Commercial |
$234.27
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$214.27
|
| Rate for Payer: PACE Medicare |
$46.58
|
| Rate for Payer: PACE SWMI |
$49.03
|
| Rate for Payer: PHP Commercial |
$53.93
|
| Rate for Payer: PHP Medicaid |
$26.28
|
| Rate for Payer: PHP Medicare Advantage |
$49.03
|
| Rate for Payer: Priority Health Choice Medicaid |
$25.64
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$250.32
|
| Rate for Payer: Priority Health Medicare |
$49.03
|
| Rate for Payer: Priority Health Narrow Network |
$200.27
|
| Rate for Payer: Railroad Medicare Medicare |
$49.03
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$251.41
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$49.03
|
| Rate for Payer: UHC Exchange |
$76.00
|
| Rate for Payer: UHC Medicaid |
$25.64
|
| Rate for Payer: UHCCP DNSP |
$49.03
|
| Rate for Payer: UHCCP Medicaid |
$25.64
|
| Rate for Payer: VA VA |
$49.03
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
IP
|
$15.92
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$11.94 |
| Max. Negotiated Rate |
$15.92 |
| Rate for Payer: Aetna Commercial |
$14.33
|
| Rate for Payer: ASR ASR |
$15.44
|
| Rate for Payer: BCBS Trust/PPO |
$13.07
|
| Rate for Payer: BCN Commercial |
$13.07
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$14.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$15.44
|
| Rate for Payer: Healthscope Whirlpool |
$15.92
|
| Rate for Payer: Mclaren Commercial |
$14.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.01
|
|
|
HC LYMPHOMA IMMUNOPHENO 2
|
Facility
|
OP
|
$15.92
|
|
|
Service Code
|
CPT 85060
|
| Hospital Charge Code |
30500014
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$5.89 |
| Max. Negotiated Rate |
$15.92 |
| Rate for Payer: Aetna Commercial |
$14.33
|
| Rate for Payer: Aetna Medicare |
$5.89
|
| Rate for Payer: ASR ASR |
$15.44
|
| Rate for Payer: BCBS Complete |
$6.37
|
| Rate for Payer: BCBS Trust/PPO |
$13.13
|
| Rate for Payer: BCN Commercial |
$13.13
|
| Rate for Payer: Cash Price |
$12.74
|
| Rate for Payer: Cofinity Commercial |
$14.96
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$12.74
|
| Rate for Payer: Healthscope Commercial |
$15.44
|
| Rate for Payer: Healthscope Whirlpool |
$15.92
|
| Rate for Payer: Mclaren Commercial |
$14.33
|
| Rate for Payer: MI Amish Medical Board Commercial |
$12.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$13.53
|
| Rate for Payer: Nomi Health Commercial |
$13.05
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$11.94
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$13.95
|
| Rate for Payer: Priority Health Narrow Network |
$11.16
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$14.01
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
OP
|
$686.66
|
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$254.06 |
| Max. Negotiated Rate |
$686.66 |
| Rate for Payer: Aetna Commercial |
$617.99
|
| Rate for Payer: Aetna Medicare |
$254.06
|
| Rate for Payer: ASR ASR |
$666.06
|
| Rate for Payer: BCBS Complete |
$274.66
|
| Rate for Payer: BCBS Trust/PPO |
$566.15
|
| Rate for Payer: BCN Commercial |
$566.15
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Commercial |
$645.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Healthscope Commercial |
$666.06
|
| Rate for Payer: Healthscope Whirlpool |
$686.66
|
| Rate for Payer: Mclaren Commercial |
$617.99
|
| Rate for Payer: MI Amish Medical Board Commercial |
$549.33
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Nomi Health Commercial |
$563.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$601.65
|
| Rate for Payer: Priority Health Narrow Network |
$481.35
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.26
|
|
|
HC LYMPH SUPPLY CUSTOM GARMEN
|
Facility
|
IP
|
$686.66
|
|
| Hospital Charge Code |
96000003
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$515.00 |
| Max. Negotiated Rate |
$686.66 |
| Rate for Payer: Aetna Commercial |
$617.99
|
| Rate for Payer: ASR ASR |
$666.06
|
| Rate for Payer: BCBS Trust/PPO |
$563.89
|
| Rate for Payer: BCN Commercial |
$563.89
|
| Rate for Payer: Cash Price |
$549.33
|
| Rate for Payer: Cofinity Commercial |
$645.46
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$549.33
|
| Rate for Payer: Healthscope Commercial |
$666.06
|
| Rate for Payer: Healthscope Whirlpool |
$686.66
|
| Rate for Payer: Mclaren Commercial |
$617.99
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$583.66
|
| Rate for Payer: Nomi Health Commercial |
$563.06
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$515.00
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$604.26
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
IP
|
$3,805.47
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$2,854.10 |
| Max. Negotiated Rate |
$3,805.47 |
| Rate for Payer: Aetna Commercial |
$3,424.92
|
| Rate for Payer: ASR ASR |
$3,691.31
|
| Rate for Payer: BCBS Trust/PPO |
$3,125.05
|
| Rate for Payer: BCN Commercial |
$3,125.05
|
| Rate for Payer: Cash Price |
$3,044.38
|
| Rate for Payer: Cofinity Commercial |
$3,577.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,044.38
|
| Rate for Payer: Healthscope Commercial |
$3,691.31
|
| Rate for Payer: Healthscope Whirlpool |
$3,805.47
|
| Rate for Payer: Mclaren Commercial |
$3,424.92
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,234.65
|
| Rate for Payer: Nomi Health Commercial |
$3,120.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,854.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,348.81
|
|
|
HC LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS
|
Facility
|
OP
|
$3,805.47
|
|
|
Service Code
|
CPT 54162
|
| Hospital Charge Code |
36100617
|
|
Hospital Revenue Code
|
361
|
| Min. Negotiated Rate |
$1,089.34 |
| Max. Negotiated Rate |
$3,805.47 |
| Rate for Payer: Aetna Commercial |
$3,424.92
|
| Rate for Payer: Aetna Medicare |
$2,082.87
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$2,603.59
|
| Rate for Payer: Amish Plain Church Group Commercial |
$2,603.59
|
| Rate for Payer: ASR ASR |
$3,691.31
|
| Rate for Payer: BCBS Complete |
$1,143.91
|
| Rate for Payer: BCBS MAPPO |
$2,082.87
|
| Rate for Payer: BCBS Trust/PPO |
$3,137.61
|
| Rate for Payer: BCN Commercial |
$3,137.61
|
| Rate for Payer: BCN Medicare Advantage |
$2,082.87
|
| Rate for Payer: Cash Price |
$3,044.38
|
| Rate for Payer: Cash Price |
$3,044.38
|
| Rate for Payer: Cofinity Commercial |
$3,577.14
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$3,044.38
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$2,082.87
|
| Rate for Payer: Healthscope Commercial |
$3,691.31
|
| Rate for Payer: Healthscope Whirlpool |
$3,805.47
|
| Rate for Payer: Humana Choice PPO Medicare |
$2,082.87
|
| Rate for Payer: Mclaren Commercial |
$3,424.92
|
| Rate for Payer: Mclaren Medicaid |
$2,082.87
|
| Rate for Payer: Mclaren Medicare |
$2,082.87
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$2,187.01
|
| Rate for Payer: Meridian Medicaid |
$1,143.91
|
| Rate for Payer: MI Amish Medical Board Commercial |
$2,395.30
|
| Rate for Payer: Molina Medicare/Medicaid |
$2,291.16
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$3,234.65
|
| Rate for Payer: Nomi Health Commercial |
$3,120.49
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$2,854.10
|
| Rate for Payer: PACE Medicare |
$1,978.73
|
| Rate for Payer: PACE SWMI |
$2,082.87
|
| Rate for Payer: PHP Commercial |
$2,291.16
|
| Rate for Payer: PHP Medicaid |
$1,116.42
|
| Rate for Payer: PHP Medicare Advantage |
$2,082.87
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,089.34
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$3,334.35
|
| Rate for Payer: Priority Health Medicare |
$2,082.87
|
| Rate for Payer: Priority Health Narrow Network |
$2,667.63
|
| Rate for Payer: Railroad Medicare Medicare |
$2,082.87
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$3,348.81
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$2,082.87
|
| Rate for Payer: UHC Exchange |
$3,228.45
|
| Rate for Payer: UHC Medicaid |
$1,089.34
|
| Rate for Payer: UHCCP DNSP |
$2,082.87
|
| Rate for Payer: UHCCP Medicaid |
$1,089.34
|
| Rate for Payer: VA VA |
$2,082.87
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
OP
|
$1,404.54
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$281.05 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,264.09
|
| Rate for Payer: Aetna Medicare |
$537.39
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$671.74
|
| Rate for Payer: Amish Plain Church Group Commercial |
$671.74
|
| Rate for Payer: ASR ASR |
$1,362.40
|
| Rate for Payer: BCBS Complete |
$295.13
|
| Rate for Payer: BCBS MAPPO |
$537.39
|
| Rate for Payer: BCBS Trust/PPO |
$1,158.04
|
| Rate for Payer: BCN Commercial |
$1,158.04
|
| Rate for Payer: BCN Medicare Advantage |
$537.39
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Commercial |
$1,320.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$537.39
|
| Rate for Payer: Healthscope Commercial |
$1,362.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,404.54
|
| Rate for Payer: Humana Choice PPO Medicare |
$537.39
|
| Rate for Payer: Mclaren Commercial |
$1,264.09
|
| Rate for Payer: Mclaren Medicaid |
$537.39
|
| Rate for Payer: Mclaren Medicare |
$537.39
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$564.26
|
| Rate for Payer: Meridian Medicaid |
$295.13
|
| Rate for Payer: MI Amish Medical Board Commercial |
$618.00
|
| Rate for Payer: Molina Medicare/Medicaid |
$591.13
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,151.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: PACE Medicare |
$510.52
|
| Rate for Payer: PACE SWMI |
$537.39
|
| Rate for Payer: PHP Commercial |
$591.13
|
| Rate for Payer: PHP Medicaid |
$288.04
|
| Rate for Payer: PHP Medicare Advantage |
$537.39
|
| Rate for Payer: Priority Health Choice Medicaid |
$281.05
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$1,230.66
|
| Rate for Payer: Priority Health Medicare |
$537.39
|
| Rate for Payer: Priority Health Narrow Network |
$984.58
|
| Rate for Payer: Railroad Medicare Medicare |
$537.39
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,236.00
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$537.39
|
| Rate for Payer: UHC Exchange |
$832.95
|
| Rate for Payer: UHC Medicaid |
$281.05
|
| Rate for Payer: UHCCP DNSP |
$537.39
|
| Rate for Payer: UHCCP Medicaid |
$281.05
|
| Rate for Payer: VA VA |
$537.39
|
|
|
HC LYSIS INTRANASAL SYNECHIA
|
Facility
|
IP
|
$1,404.54
|
|
|
Service Code
|
CPT 30560
|
| Hospital Charge Code |
76100452
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,053.40 |
| Max. Negotiated Rate |
$1,404.54 |
| Rate for Payer: Aetna Commercial |
$1,264.09
|
| Rate for Payer: ASR ASR |
$1,362.40
|
| Rate for Payer: BCBS Trust/PPO |
$1,153.41
|
| Rate for Payer: BCN Commercial |
$1,153.41
|
| Rate for Payer: Cash Price |
$1,123.63
|
| Rate for Payer: Cofinity Commercial |
$1,320.27
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$1,123.63
|
| Rate for Payer: Healthscope Commercial |
$1,362.40
|
| Rate for Payer: Healthscope Whirlpool |
$1,404.54
|
| Rate for Payer: Mclaren Commercial |
$1,264.09
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$1,193.86
|
| Rate for Payer: Nomi Health Commercial |
$1,151.72
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$1,053.40
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$1,236.00
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
IP
|
$7,940.33
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$5,955.25 |
| Max. Negotiated Rate |
$7,940.33 |
| Rate for Payer: Aetna Commercial |
$7,146.30
|
| Rate for Payer: ASR ASR |
$7,702.12
|
| Rate for Payer: BCBS Trust/PPO |
$6,520.60
|
| Rate for Payer: BCN Commercial |
$6,520.60
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cofinity Commercial |
$7,463.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,352.26
|
| Rate for Payer: Healthscope Commercial |
$7,702.12
|
| Rate for Payer: Healthscope Whirlpool |
$7,940.33
|
| Rate for Payer: Mclaren Commercial |
$7,146.30
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,749.28
|
| Rate for Payer: Nomi Health Commercial |
$6,511.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,955.25
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,987.49
|
|
|
HC LYSIS OF LABIAL LESION(S)
|
Facility
|
OP
|
$7,940.33
|
|
|
Service Code
|
CPT 56441
|
| Hospital Charge Code |
76100516
|
|
Hospital Revenue Code
|
761
|
| Min. Negotiated Rate |
$1,686.93 |
| Max. Negotiated Rate |
$7,940.33 |
| Rate for Payer: Aetna Commercial |
$7,146.30
|
| Rate for Payer: Aetna Medicare |
$3,225.49
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$4,031.86
|
| Rate for Payer: Amish Plain Church Group Commercial |
$4,031.86
|
| Rate for Payer: ASR ASR |
$7,702.12
|
| Rate for Payer: BCBS Complete |
$1,771.44
|
| Rate for Payer: BCBS MAPPO |
$3,225.49
|
| Rate for Payer: BCBS Trust/PPO |
$6,546.80
|
| Rate for Payer: BCN Commercial |
$6,546.80
|
| Rate for Payer: BCN Medicare Advantage |
$3,225.49
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cash Price |
$6,352.26
|
| Rate for Payer: Cofinity Commercial |
$7,463.91
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$6,352.26
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$3,225.49
|
| Rate for Payer: Healthscope Commercial |
$7,702.12
|
| Rate for Payer: Healthscope Whirlpool |
$7,940.33
|
| Rate for Payer: Humana Choice PPO Medicare |
$3,225.49
|
| Rate for Payer: Mclaren Commercial |
$7,146.30
|
| Rate for Payer: Mclaren Medicaid |
$3,225.49
|
| Rate for Payer: Mclaren Medicare |
$3,225.49
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$3,386.76
|
| Rate for Payer: Meridian Medicaid |
$1,771.44
|
| Rate for Payer: MI Amish Medical Board Commercial |
$3,709.31
|
| Rate for Payer: Molina Medicare/Medicaid |
$3,548.04
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$6,749.28
|
| Rate for Payer: Nomi Health Commercial |
$6,511.07
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$5,955.25
|
| Rate for Payer: PACE Medicare |
$3,064.22
|
| Rate for Payer: PACE SWMI |
$3,225.49
|
| Rate for Payer: PHP Commercial |
$3,548.04
|
| Rate for Payer: PHP Medicaid |
$1,728.86
|
| Rate for Payer: PHP Medicare Advantage |
$3,225.49
|
| Rate for Payer: Priority Health Choice Medicaid |
$1,686.93
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$6,957.32
|
| Rate for Payer: Priority Health Medicare |
$3,225.49
|
| Rate for Payer: Priority Health Narrow Network |
$5,566.17
|
| Rate for Payer: Railroad Medicare Medicare |
$3,225.49
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$6,987.49
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$3,225.49
|
| Rate for Payer: UHC Exchange |
$4,999.51
|
| Rate for Payer: UHC Medicaid |
$1,686.93
|
| Rate for Payer: UHCCP DNSP |
$3,225.49
|
| Rate for Payer: UHCCP Medicaid |
$1,686.93
|
| Rate for Payer: VA VA |
$3,225.49
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
IP
|
$66.59
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$49.94 |
| Max. Negotiated Rate |
$66.59 |
| Rate for Payer: Aetna Commercial |
$59.93
|
| Rate for Payer: ASR ASR |
$64.59
|
| Rate for Payer: BCBS Trust/PPO |
$54.68
|
| Rate for Payer: BCN Commercial |
$54.68
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$62.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Healthscope Commercial |
$64.59
|
| Rate for Payer: Healthscope Whirlpool |
$66.59
|
| Rate for Payer: Mclaren Commercial |
$59.93
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.60
|
|
|
HC LYSOZYME (MURAMIDASE)
|
Facility
|
OP
|
$66.59
|
|
|
Service Code
|
CPT 85549
|
| Hospital Charge Code |
30500108
|
|
Hospital Revenue Code
|
305
|
| Min. Negotiated Rate |
$9.81 |
| Max. Negotiated Rate |
$66.59 |
| Rate for Payer: Aetna Commercial |
$59.93
|
| Rate for Payer: Aetna Medicare |
$18.75
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$23.44
|
| Rate for Payer: Amish Plain Church Group Commercial |
$23.44
|
| Rate for Payer: ASR ASR |
$64.59
|
| Rate for Payer: BCBS Complete |
$10.30
|
| Rate for Payer: BCBS MAPPO |
$18.75
|
| Rate for Payer: BCBS Trust/PPO |
$54.90
|
| Rate for Payer: BCN Commercial |
$54.90
|
| Rate for Payer: BCN Medicare Advantage |
$18.75
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cash Price |
$53.27
|
| Rate for Payer: Cofinity Commercial |
$62.59
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$53.27
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$18.75
|
| Rate for Payer: Healthscope Commercial |
$64.59
|
| Rate for Payer: Healthscope Whirlpool |
$66.59
|
| Rate for Payer: Humana Choice PPO Medicare |
$18.75
|
| Rate for Payer: Mclaren Commercial |
$59.93
|
| Rate for Payer: Mclaren Medicaid |
$18.75
|
| Rate for Payer: Mclaren Medicare |
$18.75
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$19.69
|
| Rate for Payer: Meridian Medicaid |
$10.30
|
| Rate for Payer: MI Amish Medical Board Commercial |
$21.56
|
| Rate for Payer: Molina Medicare/Medicaid |
$20.62
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$56.60
|
| Rate for Payer: Nomi Health Commercial |
$54.60
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$49.94
|
| Rate for Payer: PACE Medicare |
$17.81
|
| Rate for Payer: PACE SWMI |
$18.75
|
| Rate for Payer: PHP Commercial |
$20.62
|
| Rate for Payer: PHP Medicaid |
$10.05
|
| Rate for Payer: PHP Medicare Advantage |
$18.75
|
| Rate for Payer: Priority Health Choice Medicaid |
$9.81
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$58.35
|
| Rate for Payer: Priority Health Medicare |
$18.75
|
| Rate for Payer: Priority Health Narrow Network |
$46.68
|
| Rate for Payer: Railroad Medicare Medicare |
$18.75
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$58.60
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$18.75
|
| Rate for Payer: UHC Exchange |
$29.06
|
| Rate for Payer: UHC Medicaid |
$9.81
|
| Rate for Payer: UHCCP DNSP |
$18.75
|
| Rate for Payer: UHCCP Medicaid |
$9.81
|
| Rate for Payer: VA VA |
$18.75
|
|
|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
IP
|
$14.28
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$10.71 |
| Max. Negotiated Rate |
$14.28 |
| Rate for Payer: Aetna Commercial |
$12.85
|
| Rate for Payer: ASR ASR |
$13.85
|
| Rate for Payer: BCBS Trust/PPO |
$11.73
|
| Rate for Payer: BCN Commercial |
$11.73
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$13.85
|
| Rate for Payer: Healthscope Whirlpool |
$14.28
|
| Rate for Payer: Mclaren Commercial |
$12.85
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Nomi Health Commercial |
$11.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.57
|
|
|
HC MAC/REGIONAL PER MINUTE
|
Facility
|
OP
|
$14.28
|
|
| Hospital Charge Code |
37000025
|
|
Hospital Revenue Code
|
370
|
| Min. Negotiated Rate |
$5.28 |
| Max. Negotiated Rate |
$14.28 |
| Rate for Payer: Aetna Commercial |
$12.85
|
| Rate for Payer: Aetna Medicare |
$5.28
|
| Rate for Payer: ASR ASR |
$13.85
|
| Rate for Payer: BCBS Complete |
$5.71
|
| Rate for Payer: BCBS Trust/PPO |
$11.77
|
| Rate for Payer: BCN Commercial |
$11.77
|
| Rate for Payer: Cash Price |
$11.42
|
| Rate for Payer: Cofinity Commercial |
$13.42
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$11.42
|
| Rate for Payer: Healthscope Commercial |
$13.85
|
| Rate for Payer: Healthscope Whirlpool |
$14.28
|
| Rate for Payer: Mclaren Commercial |
$12.85
|
| Rate for Payer: MI Amish Medical Board Commercial |
$11.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$12.14
|
| Rate for Payer: Nomi Health Commercial |
$11.71
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$10.71
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$12.51
|
| Rate for Payer: Priority Health Narrow Network |
$10.01
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$12.57
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
OP
|
$45.84
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.23 |
| Max. Negotiated Rate |
$67.20 |
| Rate for Payer: Aetna Commercial |
$41.26
|
| Rate for Payer: Aetna Medicare |
$4.27
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.34
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.34
|
| Rate for Payer: ASR ASR |
$44.46
|
| Rate for Payer: BCBS Complete |
$2.35
|
| Rate for Payer: BCBS MAPPO |
$4.27
|
| Rate for Payer: BCBS Trust/PPO |
$37.80
|
| Rate for Payer: BCN Commercial |
$37.80
|
| Rate for Payer: BCN Medicare Advantage |
$4.27
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cofinity Commercial |
$43.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.67
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.27
|
| Rate for Payer: Healthscope Commercial |
$44.46
|
| Rate for Payer: Healthscope Whirlpool |
$45.84
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.27
|
| Rate for Payer: Mclaren Commercial |
$41.26
|
| Rate for Payer: Mclaren Medicaid |
$4.27
|
| Rate for Payer: Mclaren Medicare |
$4.27
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.48
|
| Rate for Payer: Meridian Medicaid |
$2.35
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.91
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.70
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.96
|
| Rate for Payer: Nomi Health Commercial |
$37.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.38
|
| Rate for Payer: PACE Medicare |
$4.06
|
| Rate for Payer: PACE SWMI |
$4.27
|
| Rate for Payer: PHP Commercial |
$4.70
|
| Rate for Payer: PHP Medicaid |
$2.29
|
| Rate for Payer: PHP Medicare Advantage |
$4.27
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.23
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$67.20
|
| Rate for Payer: Priority Health Medicare |
$4.27
|
| Rate for Payer: Priority Health Narrow Network |
$53.76
|
| Rate for Payer: Railroad Medicare Medicare |
$4.27
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.34
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.27
|
| Rate for Payer: UHC Exchange |
$6.62
|
| Rate for Payer: UHC Medicaid |
$2.23
|
| Rate for Payer: UHCCP DNSP |
$4.27
|
| Rate for Payer: UHCCP Medicaid |
$2.23
|
| Rate for Payer: VA VA |
$4.27
|
|
|
HC MACROSCOPIC EXAM ARTHROPOD
|
Facility
|
IP
|
$45.84
|
|
|
Service Code
|
CPT 87168
|
| Hospital Charge Code |
30600092
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$34.38 |
| Max. Negotiated Rate |
$45.84 |
| Rate for Payer: Aetna Commercial |
$41.26
|
| Rate for Payer: ASR ASR |
$44.46
|
| Rate for Payer: BCBS Trust/PPO |
$37.64
|
| Rate for Payer: BCN Commercial |
$37.64
|
| Rate for Payer: Cash Price |
$36.67
|
| Rate for Payer: Cofinity Commercial |
$43.09
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$36.67
|
| Rate for Payer: Healthscope Commercial |
$44.46
|
| Rate for Payer: Healthscope Whirlpool |
$45.84
|
| Rate for Payer: Mclaren Commercial |
$41.26
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.96
|
| Rate for Payer: Nomi Health Commercial |
$37.59
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$34.38
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$40.34
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
IP
|
$44.94
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$33.70 |
| Max. Negotiated Rate |
$44.94 |
| Rate for Payer: Aetna Commercial |
$40.45
|
| Rate for Payer: ASR ASR |
$43.59
|
| Rate for Payer: BCBS Trust/PPO |
$36.90
|
| Rate for Payer: BCN Commercial |
$36.90
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$42.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Healthscope Commercial |
$43.59
|
| Rate for Payer: Healthscope Whirlpool |
$44.94
|
| Rate for Payer: Mclaren Commercial |
$40.45
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$36.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.55
|
|
|
HC MACROSCOPIC EXAM PARASITE
|
Facility
|
OP
|
$44.94
|
|
|
Service Code
|
CPT 87169
|
| Hospital Charge Code |
30600093
|
|
Hospital Revenue Code
|
306
|
| Min. Negotiated Rate |
$2.25 |
| Max. Negotiated Rate |
$53.88 |
| Rate for Payer: Aetna Commercial |
$40.45
|
| Rate for Payer: Aetna Medicare |
$4.31
|
| Rate for Payer: Allen County Amish Medical Aid Commercial |
$5.39
|
| Rate for Payer: Amish Plain Church Group Commercial |
$5.39
|
| Rate for Payer: ASR ASR |
$43.59
|
| Rate for Payer: BCBS Complete |
$2.37
|
| Rate for Payer: BCBS MAPPO |
$4.31
|
| Rate for Payer: BCBS Trust/PPO |
$37.05
|
| Rate for Payer: BCN Commercial |
$37.05
|
| Rate for Payer: BCN Medicare Advantage |
$4.31
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cash Price |
$35.95
|
| Rate for Payer: Cofinity Commercial |
$42.24
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$35.95
|
| Rate for Payer: Health Alliance Plan Medicare Advantage |
$4.31
|
| Rate for Payer: Healthscope Commercial |
$43.59
|
| Rate for Payer: Healthscope Whirlpool |
$44.94
|
| Rate for Payer: Humana Choice PPO Medicare |
$4.31
|
| Rate for Payer: Mclaren Commercial |
$40.45
|
| Rate for Payer: Mclaren Medicaid |
$4.31
|
| Rate for Payer: Mclaren Medicare |
$4.31
|
| Rate for Payer: Meridian Complete - MI Health Link - DSNP/Wellcare - Medicare Advantage |
$4.53
|
| Rate for Payer: Meridian Medicaid |
$2.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$4.96
|
| Rate for Payer: Molina Medicare/Medicaid |
$4.74
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$38.20
|
| Rate for Payer: Nomi Health Commercial |
$36.85
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$33.70
|
| Rate for Payer: PACE Medicare |
$4.09
|
| Rate for Payer: PACE SWMI |
$4.31
|
| Rate for Payer: PHP Commercial |
$4.74
|
| Rate for Payer: PHP Medicaid |
$2.31
|
| Rate for Payer: PHP Medicare Advantage |
$4.31
|
| Rate for Payer: Priority Health Choice Medicaid |
$2.25
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$53.88
|
| Rate for Payer: Priority Health Medicare |
$4.31
|
| Rate for Payer: Priority Health Narrow Network |
$43.10
|
| Rate for Payer: Railroad Medicare Medicare |
$4.31
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$39.55
|
| Rate for Payer: UHC Dual Complete DSNP/Medicare Advantage |
$4.31
|
| Rate for Payer: UHC Exchange |
$6.68
|
| Rate for Payer: UHC Medicaid |
$2.25
|
| Rate for Payer: UHCCP DNSP |
$4.31
|
| Rate for Payer: UHCCP Medicaid |
$2.25
|
| Rate for Payer: VA VA |
$4.31
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
IP
|
$994.85
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$746.14 |
| Max. Negotiated Rate |
$994.85 |
| Rate for Payer: Aetna Commercial |
$895.37
|
| Rate for Payer: ASR ASR |
$965.00
|
| Rate for Payer: BCBS Trust/PPO |
$816.97
|
| Rate for Payer: BCN Commercial |
$816.97
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cofinity Commercial |
$935.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.88
|
| Rate for Payer: Healthscope Commercial |
$965.00
|
| Rate for Payer: Healthscope Whirlpool |
$994.85
|
| Rate for Payer: Mclaren Commercial |
$895.37
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.62
|
| Rate for Payer: Nomi Health Commercial |
$815.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.14
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$875.47
|
|
|
HC MAG 3 TC 99M PER STUDY
|
Facility
|
OP
|
$994.85
|
|
|
Service Code
|
HCPCS A9562
|
| Hospital Charge Code |
34300016
|
|
Hospital Revenue Code
|
343
|
| Min. Negotiated Rate |
$283.76 |
| Max. Negotiated Rate |
$994.85 |
| Rate for Payer: Aetna Commercial |
$895.37
|
| Rate for Payer: Aetna Medicare |
$368.09
|
| Rate for Payer: ASR ASR |
$965.00
|
| Rate for Payer: BCBS Complete |
$397.94
|
| Rate for Payer: BCBS Trust/PPO |
$820.25
|
| Rate for Payer: BCN Commercial |
$820.25
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cash Price |
$795.88
|
| Rate for Payer: Cofinity Commercial |
$935.16
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$795.88
|
| Rate for Payer: Healthscope Commercial |
$965.00
|
| Rate for Payer: Healthscope Whirlpool |
$994.85
|
| Rate for Payer: Mclaren Commercial |
$895.37
|
| Rate for Payer: MI Amish Medical Board Commercial |
$795.88
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$845.62
|
| Rate for Payer: Nomi Health Commercial |
$815.78
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$746.14
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$354.70
|
| Rate for Payer: Priority Health Narrow Network |
$283.76
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$875.47
|
|
|
HC MAGGOT THERAPY
|
Facility
|
IP
|
$1,114.27
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$835.70 |
| Max. Negotiated Rate |
$1,114.27 |
| Rate for Payer: Aetna Commercial |
$1,002.84
|
| Rate for Payer: ASR ASR |
$1,080.84
|
| Rate for Payer: BCBS Trust/PPO |
$915.04
|
| Rate for Payer: BCN Commercial |
$915.04
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$1,047.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,080.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,114.27
|
| Rate for Payer: Mclaren Commercial |
$1,002.84
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$980.56
|
|
|
HC MAGGOT THERAPY
|
Facility
|
OP
|
$1,114.27
|
|
| Hospital Charge Code |
27000634
|
|
Hospital Revenue Code
|
270
|
| Min. Negotiated Rate |
$412.28 |
| Max. Negotiated Rate |
$1,114.27 |
| Rate for Payer: Aetna Commercial |
$1,002.84
|
| Rate for Payer: Aetna Medicare |
$412.28
|
| Rate for Payer: ASR ASR |
$1,080.84
|
| Rate for Payer: BCBS Complete |
$445.71
|
| Rate for Payer: BCBS Trust/PPO |
$918.72
|
| Rate for Payer: BCN Commercial |
$918.72
|
| Rate for Payer: Cash Price |
$891.42
|
| Rate for Payer: Cofinity Commercial |
$1,047.41
|
| Rate for Payer: Encore Health Key Benefits Commercial |
$891.42
|
| Rate for Payer: Healthscope Commercial |
$1,080.84
|
| Rate for Payer: Healthscope Whirlpool |
$1,114.27
|
| Rate for Payer: Mclaren Commercial |
$1,002.84
|
| Rate for Payer: MI Amish Medical Board Commercial |
$891.42
|
| Rate for Payer: Multiplan/Beech St/PHCS Commercial |
$947.13
|
| Rate for Payer: Nomi Health Commercial |
$913.70
|
| Rate for Payer: Opus (Opus Packaging Group) HMA |
$835.70
|
| Rate for Payer: Priority Health Cigna Priority Health/HMO/PPO/Tiered Network |
$976.32
|
| Rate for Payer: Priority Health Narrow Network |
$781.10
|
| Rate for Payer: UHC All Payor (Choice/PPO) + Core |
$980.56
|
|
